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• Laboratory and Diagnostic Testing during the First Prenatal Visit

  Done to screen for abnormal results; intervention can be implemented as soon as possible or at follow-up visits, as indicated
• Complete blood count (CBC)


  A series of blood tests that provide information on the hematologic system as well as other body systems; advantages include that it is inexpensive, easy to perform, and results are quickly available
• Blood group and Rh typing


  To determine the client's blood group and Rh status to identify a fetus at risk for developing erythroblastosis fetalis or hyperbilirubinemia in the neonatal period
• TORCH


  A group of infection caused by viruses and protozoa that cause serious fetal problems when contracted by the mother during pregnancy
• Toxoplasmosis


  Infection with the protozoan parasite toxoplasma gondii
• Toxoplasmosis transmission


  • Development of this infection in the mother is associated with consumption of infested undercooked meat and poor hand-washing after handling cat litter
• Toxoplasmosis diagnostics


  Serologic testing; the indirect fluorescent antibody test is the most commonly used
• Toxoplasmosis maternal effects


  Flu-like symptoms in acute phase
• Toxoplasmosis fetal/neonatal effects


  Miscarriage is likely in early pregnancy; in neonates central nervous system lesion can result in hydrocephaly, microcephaly, chronic retinitis, and seizures
• Other infections, usually Hepatitis Virus


  Infection with the hepatitis A or B virus; hepatitis B is the most common in the fetus
• Hepatitis transmission


  • Hepatitis B can be transmitted to the fetus via the placenta, but transmission usually occurs when the infant is exposed to blood and genital secretions during labor in delivery
• Hepatitis diagnostics


  Hepatitis B is detected through the hepatitis B surface antigen (HbsAg)
• Hepatitis maternal effects


  Fever, malaise, nausea, and abdominal comfort; may be associated with liver failure
• Hepatitis fetal/neonatal effects


  Preterm birth, hepatitis infection, and intrauterine fetal death
• Rubella


  Infection with rubella virus, sometimes called German measles or 3-day measles
• Rubella transmission


  • Spread through droplet
• Rubella diagnostics


  An IgG antibody are measured to determines client's rubella immunity status
• Rubella maternal effects


  Fever, rash, and mild lymphedema
• Rubella fetal/neonatal effects


  Miscarriage, congenital anomalies, and death
• Cytomegalovirus (CVM)


  Exposure to cytomegalovirus
• CVM transmission


  • CVM can be transmitted through respiratory droplet, semen, cervical and vaginal secretions, breast milk, placental tissue, urine, feces, and banked blood
• CVM diagnostics


  Viral culture is the most definitive diagnostic tool; CVM antibodies indicate a recent infection
• CVM maternal effects


  Asymptomatic illness, cervical discharge, and mononucleosis-like
• Syndrome


  A group of symptoms that occur together and characterize a particular abnormal condition
• Herpes Simplex Virus (HSV)


  A virus that causes a contagious infection
• Sexually Transmitted Infections (STIs)

  Also called venereal diseases, caused by bacteria, viruses, protozoa, or ectoparasites
• Human papillomavirus (HPV)


  Sometimes called genital or venereal warts, caused by spread of the HPV through sexual contact
• Human Immunodeficiency Virus (HIV)


  A virus that causes a chronic and potentially life-threatening condition
• Group B Streptococcus (GBS)


  A type of bacteria that can cause serious infections in newborns
• Syphilis


  A sexually transmitted infection caused by the bacterium Treponema pallidum
• Gonorrhea


  Caused by Neisseria gonorrhoeae, an aerobic, gram-negative diplococci bacteria, transmitted by all types of sexual activity; neonates can acquire the infection by exposure to the bacteria in the birth canal
• Chlamydia


  The Chlamydia trachomatis bacteria is spread through sexual contact
• The pH may be decreased with poor glucose metabolism and ketone acids in the urine
• Specific gravity may be increased with dehydration caused by excessive vomiting as seen in hyperemesis gravidarum
• Color should be pale yellow to amber depending on foods ingested and concentration
• Glucose reabsorption is impaired in pregnancy resulting in spilling of glucose in urine at a blood glucose level of 160mg/dL
• Protein may normally be found in the urine during pregnancy at a level of trace to +1 using the dipstick method; increased protein may indicate pregnancy induced hypertension (gestational hypertension)
• WBCs or nitrates can indicate a possible UTI which can place the clients at risk for preterm labor
• Casts, which are formed from clumps of materials or cells in the renal distal and collecting tubules, form when the urine is acidic and concentrated; they can be associated with proteinuria and stasis in the renal tubules
• Ketones may indicate diabetes and hyperglycemia